Predictive scores in trauma. Controversy

Abstract

Introduction. More than 50 score systems have been published for the classification of injured patients in emergency or intensive care medicine. A quantitative method for measuring trauma severity has many potential applications: patient triage, a common terminology about injuries severity, prognosis assessment, trauma care audit and epidemiological. Aim of the study. To analyze the main scoring systems used in today’s trauma care and to evaluate their efficiency in predicting the injury severity. To analyze specific alterations made to level up the sensibility and specificity of a score on different populations and to find different studies where trauma scores are being compared. And finally, the aim of the study is to find the advantages and disadvantages of different trauma scores. Materials and methods. A systematic review of the literature using computer searching of Hinari Access to Research for Health Program database using PubMed Entre interface and Scopus. We have selected articles about the main scoring systems used in today's trauma care, as well as studies where they a being compared or where modifications are made to trauma scores. Results. Trauma scores were introduced more than 30 years ago, for assigning numerical values to anatomical lesions and physiological changes after an injury. More than 50 score systems have been published for the classification of injured patients in emergency or intensive care medicine. This large number indicates that the prediction of outcome is and never will be perfect because the severity of the injury is complex and difficult to quantify. There is no consensus between the major trauma registries regarding the probability of survival estimation in major trauma patients. The German, United Kingdom trauma registries scores are based on the largest population, with demographics updated to the nowadays European injury pattern. Conclusions. Even if they are imperfect, trauma scores are essential tools in trauma patients’ management and research. Using large national databases allow better research, validation and development of scoring systems, and there is a need of the creation of an international database and further research to create a score perfect for each population.